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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Outcome of 312 Japanese patients with carotid endarterectomy and factors associated with cardiovascular events - A single-center study in Japan
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Outcome of 312 Japanese patients with carotid endarterectomy and factors associated with cardiovascular events - A single-center study in Japan

机译：312位日本颈动脉内膜切除术患者的结果及与心血管事件相关的因素-日本的单中心研究

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Background: There have only been a few reports regarding the outcomes and risk factors after CEA. To clarify the factors associated with outcome in patients with carotid stenosis who underwent carotid endarterectomy (CEA), we investigated cardiovascular events and mortality in the Kyushu Medical Center in Japan. Methods: We consecutively registered patients with significant carotid stenosis who had CEA performed over 10 years and compared the incidences of stroke, myocardial infarction, and death. On admission, we evaluated medical records for stroke risk factors, including hypertension, diabetes mellitus, hypercholesterolemia, atrial fibrillation, and current smoking habits. When performing CEA, blood pressure, heart rate, blood gases, and Doppler flow parameters in the carotid artery, and an electroencephalogram, were continuously monitored during the procedure. A shunt tube was inserted into both ends of the carotid artery, and a microscope was used. Although it was recommended that patients be evaluated by magnetic resonance imaging and ultrasound after the operation, we attempted to obtain information from the patient or a family member through a questionnaire or telephone survey if a patient did not come for assessment. We determined the factors associated with stroke, myocardial infarction, and death using Kaplan-Meier analyses. Results: Of 312 CEA patients, 302 (96.8%) with confirmed outcomes were analyzed. We found that a factor associated with stroke was a history of ischemic stroke (P =.028). A history of myocardial infarction (P =.009) and the presence of peripheral arterial disease (PAD) (P =.001) were factors related to the future occurrence of myocardial infarction. Perioperative complications occurred in 6 patients (1.99%) including 1 death because of sepsis and 1 major ipsilateral stroke. Of the 302 patients who underwent CEA, 43 patients died in the follow-up period, and the 5-year survival rate was 83.9%. The number of patients who died because of myocardial infarction and cancer was 9 for each, and they were the leading causes of their death. Only 1 patient died because of stroke (2.3%). Patients with PAD had a significantly high mortality (P <.001). Conclusions: In patients who underwent CEA, a risk factor of future stroke was a history of stroke. A history of myocardial infarction or PAD was strongly associated with future occurrence of myocardial infarction or high mortality.
机译：背景：CEA术后关于结局和危险因素的报道很少。为了弄清接受颈动脉内膜切除术（CEA）的颈动脉狭窄患者预后的相关因素，我们在日本九州医学中心调查了心血管事件和死亡率。方法：我们连续登记了10年来行CEA的严重颈动脉狭窄患者，并比较了中风，心肌梗塞和死亡的发生率。入院时，我们评估了中风危险因素的医学记录，包括高血压，糖尿病，高胆固醇血症，心房颤动和当前吸烟习惯。进行CEA时，在手术过程中会连续监测血压，心率，血气和颈动脉多普勒血流参数以及脑电图。将分流管插入颈动脉的两端，并使用显微镜。尽管建议在手术后通过磁共振成像和超声对患者进行评估，但是如果患者没有来评估，我们尝试通过问卷或电话调查从患者或家庭成员那里获取信息。我们使用Kaplan-Meier分析确定了与中风，心肌梗塞和死亡相关的因素。结果：在312例CEA患者中，分析了302例（96.8％）确诊结果。我们发现与中风相关的一个因素是缺血性中风的病史（P = .028）。心肌梗塞病史（P = .009）和周围动脉疾病（PAD）的存在（P = .001）是与将来发生心肌梗塞有关的因素。围手术期并发症发生在6例患者中（1.99％），包括因败血症和1个主要同侧中风导致1例死亡。在302例接受CEA的患者中，有43例在随访期间死亡，5年生存率为83.9％。死于心肌梗塞和癌症的患者人数均为9，是导致死亡的主要原因。仅1例患者因中风死亡（2.3％）。 PAD患者的死亡率显着较高（P <.001）。结论：接受CEA的患者中，未来中风的危险因素是中风病史。心肌梗塞或PAD的病史与将来发生心肌梗塞或高死亡率密切相关。

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